ObjectiveTo investigate the clinical efficacy and potential mechanism of Shengmai Jiuxin decoction in the treatment of acute decompensated heart failure （ADHF） with the traditional Chinese medicine （TCM） pattern of Qi and Yin deficiency， Yang deficiency， and blood stasis. MethodsA total of 68 patients diagnosed with ADHF of Qi and Yin deficiency， Yang deficiency， and blood stasis type were randomly assigned to an observation group （34 cases） and a control group （34 cases）. Both groups received conventional Western medical treatment， while the observation group was additionally administered Shengmai Jiuxin decoction. Parameters compared before and after treatment included： TCM syndrome score， TCM syndrome efficacy， New York Heart Association （NYHA） functional classification， left ventricular ejection fraction （LVEF）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， six-minute walk distance （6MWD）， hypoxia-inducible factor-1 alpha （HIF-1α）， vascular endothelial growth factor A （VEGF-A）， Caspase-3， and the number of rehospitalizations for heart failure within one month after discharge. ResultsThere were no significant differences in sex， age， vital signs， or underlying diseases between the two groups. Compared with baseline， both groups exhibited significant reductions in TCM syndrome scores， NT-proBNP， and HIF-1α levels （P<0.01）， as well as significant increases in 6MWD， LVEF， VEGF-A， and Caspase-3 levels （P<0.05， P<0.01）. After treatment， the observation group showed significantly greater reductions in TCM syndrome score， NT-proBNP， HIF-1α， and Caspase-3 levels compared with the control group （P<0.05） and significantly greater increases in 6MWD， TCM syndrome efficacy， and VEGF-A levels （P<0.05）. No significant differences were observed between the groups in NYHA functional classification， LVEF， or the number of rehospitalizations for heart failure within one month after discharge. No drug-related adverse events were reported in either group during the treatment period. ConclusionShengmai Jiuxin decoction can improve cardiac function and clinical symptoms in patients with ADHF of Qi and Yin deficiency， Yang deficiency， and blood stasis type. Its mechanisms may be related to the regulation of the HIF-1 signaling pathway by modulating targets such as HIF-1α， VEGF-A， and Caspase-3.

ObjectiveTo investigate the clinical efficacy and potential mechanism of Shengmai Jiuxin decoction in the treatment of acute decompensated heart failure （ADHF） with the traditional Chinese medicine （TCM） pattern of Qi and Yin deficiency， Yang deficiency， and blood stasis. MethodsA total of 68 patients diagnosed with ADHF of Qi and Yin deficiency， Yang deficiency， and blood stasis type were randomly assigned to an observation group （34 cases） and a control group （34 cases）. Both groups received conventional Western medical treatment， while the observation group was additionally administered Shengmai Jiuxin decoction. Parameters compared before and after treatment included： TCM syndrome score， TCM syndrome efficacy， New York Heart Association （NYHA） functional classification， left ventricular ejection fraction （LVEF）， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， six-minute walk distance （6MWD）， hypoxia-inducible factor-1 alpha （HIF-1α）， vascular endothelial growth factor A （VEGF-A）， Caspase-3， and the number of rehospitalizations for heart failure within one month after discharge. ResultsThere were no significant differences in sex， age， vital signs， or underlying diseases between the two groups. Compared with baseline， both groups exhibited significant reductions in TCM syndrome scores， NT-proBNP， and HIF-1α levels （P<0.01）， as well as significant increases in 6MWD， LVEF， VEGF-A， and Caspase-3 levels （P<0.05， P<0.01）. After treatment， the observation group showed significantly greater reductions in TCM syndrome score， NT-proBNP， HIF-1α， and Caspase-3 levels compared with the control group （P<0.05） and significantly greater increases in 6MWD， TCM syndrome efficacy， and VEGF-A levels （P<0.05）. No significant differences were observed between the groups in NYHA functional classification， LVEF， or the number of rehospitalizations for heart failure within one month after discharge. No drug-related adverse events were reported in either group during the treatment period. ConclusionShengmai Jiuxin decoction can improve cardiac function and clinical symptoms in patients with ADHF of Qi and Yin deficiency， Yang deficiency， and blood stasis type. Its mechanisms may be related to the regulation of the HIF-1 signaling pathway by modulating targets such as HIF-1α， VEGF-A， and Caspase-3.

Objective To establish an artificial intelligence (AI)-assisted platform for detection of parasite eggs, and to evaluate its detection efficiency and accuracy, so as to provide technical supports for elimination of parasitic diseases. Methods A total of 1 003 slides of Enterobius vermicularis, horkworm, Trichuris trichiura, Clonorchis sinensis, Taenia, Ascaris lumbricoides, Schistosoma japonicum, Paragonimus westermani and Fasciolopsis buski eggs were collected, and converted into digital images with an automatated scanning microscope to create a dataset. Based on the Object Detection platform on the Baidu Easy DL model, an AI-assisted platform for detection of parasite eggs was created through procedures of uploading, labeling, training, evaluation and optimization. Then, 70% of the datasets were randomly selected for model training, and the precision, recall and average accuracy were calculated to evaluate the effectiveness of platform for recognition of parasite eggs. In addition, the platform was deployed on the computer and smart phone terminals for use. Results An AI-assisted platform for detection of parasite eggs was successfully created. If the platform was deployed using the public cloud application programming interface (API), the average accuracy, precision and recall of the platform were 93.42%, 92.55% and 89.32% for recognition of parasite eggs. If the platform was deployed using the offline software development kit (SDK), the average accuracy, precision and recall of the platform were 92.97%, 94.78% and 87.63% for recognition of parasite eggs. In addition, the precision of the platform was 97.00% and 96.23% for identification of Taenia and C. sinensis eggs, respectively. Conclusions The AI-assisted platform for detection of parasite eggs has been successfully created, which is high in the accuracy for recognition of parasite eggs and convenient in use. This platform may provide a powerful technical support for parasitic disease diagnosis.

Aging and age-related ailments have emerged as critical challenges and great burdens within the global contemporary society.Addressing these concerns is an imperative task,with the aims of postponing the aging process and finding effective treatments for age-related degenerative diseases.Recent investigations have highlighted the significant roles of nicotinamide adenine dinucleotide(NAD+)in the realm of anti-aging.It has been empirically evidenced that supplementation with nicotinamide mononucleotide(NMN)can elevate NAD+levels in the body,thereby ameliorating certain age-related degenerative diseases.The principal anti-aging mechanisms of NMN essentially lie in its impact on cellular energy metabolism,inhibition of cell apoptosis,modulation of immune function,and preservation of genomic stability,which collectively contribute to the deferral of the aging process.This paper critically reviews and evaluates existing research on the anti-aging mechanisms of NMN,elucidates the inherent limitations of current research,and proposes novel avenues for anti-aging investigations.

Objective To investigate the efficacy and safety of ultrafiltration therapy in elderly patients with congestive heart failure(CHF)and frailty.Methods A total of 88 hospitalized elderly patients with CHF and frailty were randomly assigned to the ultrafiltration group(n=44)and the control group(n=44).The control group treated with standard drug therapy.The ultrafiltration group treated with ultrafiltration,however,diuretics were not used during ultrafiltration treatment.Efficacy assessment was compared between the two groups,including patient body weight,N-terminal pro-brain natriuretic peptide(NT-proBNP)levels at 48 hours after treatment,dyspnea severity scores at 48 hours and 1 week after treatment,hospitalization duration and readmission rate within 3 months.Safety assessment parameters included serum creatinine,urea nitrogen,Na+and K+concentration at 48 hours after treatment and creatinine level 1 week after treatment.Results Efficacy assessment indicated that at 48 hours after treatment,both groups showed a significant reduction in patient body weight and NT-proBNP levels compared to pre-treatment levels(P＜0.05).However,there were no significant difference in body weight and NT-proBNP levels before and after treatment between the two groups(P＞0.05).Dyspnea severity scores for both groups increased at 48 hours after treatment,then decreased at 1 week after treatment.The ultrafiltration group exhibited higher dyspnea severity scores than that of the control group at 48 hours after treatment(P＜0.05).The length of hospital stay and the rate of re-hospitalization within 3 months were lower in the ultrafiltration group compared to those of the control group(P＜0.05).Safety assessment revealed that there were no significant differences in serum urea nitrogen and Na+levels before and 48 hours after treatment between the two groups(P＞0.05).However,serum K+levels were higher after 48-hours treatment in the ultrafiltration group than those of the control group(P＜0.05).There were no significant changes in creatinine levels before and after treatment in the control group(P＞0.05),while creatinine levels were lower 1 week after treatment in the ultrafiltration group compared to those of pre-treatment and 48 hours after treatment,and were lower than those of the control group(P＜0.05).Conclusion Ultrafiltration is a safe and effective method for elderly patients with CHF and frailty.

Objective:To observe any effect of repeated magnetic stimulation of the spine on lower urinary tract function and the life quality of patients with neurogenic bladder after suprasacral spinal cord injury (SCI).Methods:Fifteen suprasacral SCI patients whose lower urinary tract function was not improving were enrolled. In the first 2 weeks, all received water drinking management and intermittent catheterization, while in the following 4 weeks they were additionally provided with daily transspinal magnetic stimulation at the level of the spinous process of the first lumbar vertebra five times a week. The stimulation frequency was 1Hz. The patients kept voiding diaries. Their urodynamics were quantified using neurogenic bladder symptom scoring (NBSS) and a life quality scale.Results:The frequency of catheterization and the average voided volume, as well as the maximum detrusor pressure during the storage phase, maximum bladder capacity, maximum urethral pressure during the voiding phase and voiding efficiency at the end of the sixth week were significantly different from those at the end of the second week and before the intervention. The average NBSS and life quality scores then showed significant differences from the earlier time points.Conclusion:Repeteitive transspinal magnetic stimulation of the spine can improve lower urinary tract functioning and the life quality of persons with neurogenic bladder after a suprasacral SCI.

Objective:To analyze the clinical characteristics and prognostic factors of high-risk neuroblastoma (HR-NB) patients with skeletal metastasis.Methods:The clinical features of 336 newly treated HR-NB patients with skeletal metastases admitted to the Department of Medical Oncology of Beijing Children′s Hospital, Capital Medical University from January 2007 to December 2018 were analyzed retrospectively.Kaplan-Meier method was used for the survival analysis, and Log- Rank test was used for univariate prognosis analysis.The Cox model was used to analyze the multifactorial prognostic analysis. Results:A total of 336 HR-NB patients were recruited, involving 188 males and 148 females with the median age of onset of at 43 (4-148) months.Skeletal metastases affected the viscerocranium (89 cases, 26.5%), neurocranium (193 cases, 57.4%), vertebrae (298 cases, 88.7%), sternum and ribs (183 cases, 54.5%), pelvis (270 cases, 80.4%), upper limbs (182 cases, 54.2%) and lower limbs (240 cases, 71.4%). The 5-year event-free survival (EFS) rate and overall survival (OS) rate were (30.4±2.7)% and (41.3±2.9)%, respectively.Univariate analysis showed a significantly lower 5-year OS rate in skeletal metastatic HR-NB patients with poor prognostic classification, the morphology of neuroblastoma (stroma-poor) and ganglioneuroblastoma (intermixed), high index of mitosis-karyorrhexis index, lactate dehydrogenase≥587 U/L, serum ferritin≥92 μg/L, MYCN amplification and 1p loss of heterozygosity, and metastases in the viscerocranium, neurocranium, vertebrae, sternum and ribs, pelvis, upper limbs and lower limbs (all P<0.05). The 5-year OS rate of HR-NB patients with all 7 regions of skeletal metastases was only (14.2±5.9)%, which was significantly lower than that in patients with a single region metastasis or multi-region metastases[(66.0±10.2)% vs.(43.6±3.4)%, χ2=45.722, P<0.05]. Cox multifactorial analysis showed that MYCN amplification ( HR=4.165, 95% CI: 2.356-7.363) and the viscerocranium metastasis ( HR=2.560, 95% CI: 1.519-4.315) were the independent risk factors affecting the prognosis of HR-NB patients with skeletal metastases (all P<0.05). Conclusions:The prognosis is extremely poor in HR-NB patients with multiple skeletal metastases at the initial diagnosis.The amplification of MYCN and the viscerocranium metastasis are the poor prognostic factors for HR-NB patients with skeletal metastases.

Claudin18.2(CLDN18.2)is a tight junction protein that is overexpressed in a variety of solid tumors such as gastrointestinal cancer and oesophageal cancer.It has been identified as a promising target and a potential biomarker to diagnose tumor,evaluate efficacy,and determine patient prognosis.TST001 is a recombinant humanized CLDN18.2 antibody that selectively binds to the extracellular loop of human Claudin18.2.In this study,we constructed a solid target radionuclide zirconium-89(89Zr)labled-TST001 to detect the expression of in the human stomach cancer BGC823CLDN18.2 cell lines.The[89Zr]Zr-des-ferrioxamine(DFO)-TST001 showed high radiochemical purity(RCP,＞99％)and specific activity(24.15±1.34 GBq/μmol),and was stable in 5％human serum albumin,and phosphate buffer saline(＞85％RCP at 96 h).The EC50 values of TST001 and DFO-TST001 were as high as 0.413±0.055 and 0.361±0.058 nM(P＞0.05),respectively.The radiotracer had a significantly higher average standard uptake values in CLDN18.2-positive tumors than in CLDN18.2-negative tumors(1.11±0.02 vs.0.49±0.03,P=0.0016)2 days post injection(p.i.).BGC823CLDN18.2 mice models showed high tumor/muscle ratios 96 h p.i.with[89Zr]Zr-DFO-TST001 was much higher than those of the other imaging groups.Immunohistochemistry results showed that BGC823CLDN18.2 tumors were highly positive(+++)for CLDN18.2,while those in the BGC823 group did not express CLDN18.2(-).The results of ex vivo biodistribution studies showed that there was a higher distribution in the BGC823CLDN18.2 tumor bearing mice(2.05±0.16％ID/g)than BGC823 mice(0.69±0.02％ID/g)and blocking group(0.72±0.02％ID/g).A dosimetry estimation study showed that the effective dose of[89Zr]Zr-DFO-TST001 was 0.0705 mSv/MBq,which is within the range of acceptable doses for nuclear medicine research.Taken together,these re-sults suggest that Good Manufacturing Practices produced by this immuno-positron emission tomog-raphy probe can detect CLDN18.2-overexpressing tumors.

Existing traditional Chinese medicine (TCM)-related databases are still insufficient in data standardization, integrity and precision, and need to be updated urgently. Herein, an Encyclopedia of Traditional Chinese Medicine version 2.0 (ETCM v2.0, http://www.tcmip.cn/ETCM2/front/#/) was constructed as the latest curated database hosting 48,442 TCM formulas recorded by ancient Chinese medical books, 9872 Chinese patent drugs, 2079 Chinese medicinal materials and 38,298 ingredients. To facilitate the mechanistic research and new drug discovery, we improved the target identification method based on a two-dimensional ligand similarity search module, which provides the confirmed and/or potential targets of each ingredient, as well as their binding activities. Importantly, five TCM formulas/Chinese patent drugs/herbs/ingredients with the highest Jaccard similarity scores to the submitted drugs are offered in ETCM v2.0, which may be of significance to identify prescriptions/herbs/ingredients with similar clinical efficacy, to summarize the rules of prescription use, and to find alternative drugs for endangered Chinese medicinal materials. Moreover, ETCM v2.0 provides an enhanced JavaScript-based network visualization tool for creating, modifying and exploring multi-scale biological networks. ETCM v2.0 may be a major data warehouse for the quality marker identification of TCMs, the TCM-derived drug discovery and repurposing, and the pharmacological mechanism investigation of TCMs against various human diseases.

Objective:To investigate the efficacy of negative pressure wound therapy (NPWT) combined with a retrograde sural neurovascular flap for the repair of foot and ankle wounds.Methods:Eighty-eight patients with foot and ankle wounds who received treatment in Shandong Wendeng Osteopathic Hospital from July 2019 to January 2020 were included in this study. They were randomly assigned to undergo either NPWT combined with retrograde sural neurovascular flap repair (observation group, n = 44) or retrograde sural neurovascular flap repair alone (control group, n = 44). Clinical efficacy, flap survival, wound healing, and postoperative ankle function scores were compared between the two groups. Results:Total response rate was significantly higher in the observation group than in the control group [97.73% (43/44) vs. 81.82% (36/44), χ2 = 6.07, P = 0.014]. Flap survival rate was significantly higher in the observation group than in the control group [100.00% (44/44) vs. 86.36% (38/44), χ2 = 4.47, P = 0.034]. Wound healing rate was significantly higher in the observation group than in the control group [97.73% (43/44) vs. 79.55% (35/44), χ2 = 7.22, P = 0.007]. Half a year after surgery, pain score, gait score, foot and ankle swelling score, range of motion of the tibiotalar joint, range of motion of the ankle joint were (1.81 ± 0.45) points, (1.40 ± 0.41) points, (1.98 ± 0.38) points, (0.41 ± 0.35) points, and (0.84 ± 0.51) points, respectively in the observation group, which were significantly lower than those in the control group ( t = 2.63, 2.62, 2.15, 2.09, 2.02, all P < 0.05). Conclusion:NPWT combined with a retrograde sural neurovascular flap greatly increases flap survival rate and wound healing rate and improves the ankle function of patients with foot and ankle wounds.